Place the heel of your other hand over the first and lace fingers together. Keep your elbows straight and align your shoulders directly over your hands. Blow in for one second, so the chest visibly rises and repeat this once. Repeat these steps three to four times. Allow the chest to fully recoil between compressions. Give two mouth-to-snout rescue breaths after each set of compressions For Medium to Giant Dogs: Position the animal on its side. Use the two-handed technique, placing your hands over the widest part of the chest.
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European Resuscitation Council Guidelines for Resuscitation 2015: Section 1. Executive summary
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Part 13: First Aid
Evidence from 1 LOE 3 bench study demonstrated elevated levels of inflammatory mediators in blister fluid of frostbite patients. In 6 LOE 5 animal studies, , — frostbite treatment that included administration of a nonsteroidal anti-inflammatory drug NSAID either before or following injury was beneficial. There is insufficient evidence for or against the use of ibuprofen or other NSAIDs as a first aid measure for victims of frostbite.
Good-quality research is needed to establish whether there is a true benefit from the use of NSAIDs for frostbite in humans, both in the prethaw and postthaw phases of injury. Does the early use of NSAIDs for frostbite lead to an increase in bleeding complications in patients treated with tPA for ongoing warm ischemia following thawing?
One LOE 2 study showed that the volume consumed must exceed the volume lost in sweat. One LOE 2 study showed that milk is more effective than water for fluid replacement for hypohydration. Milk is an acceptable alternative. The volume consumed should exceed the volume lost in sweat. What is the best fluid composition for oral rehydration? Are there benefits of cooling with water immersion versus water spray?
Before You Start CPR
Because education in first aid continues to be undocumented in a scholarly way, many questions remain. What is the best way to teach first aid skills? Evidence shows a deterioration of skills almost from the moment that a course is completed. How does one ensure that the skills, once learned, are retained so they are available when needed? The progress in technology has unleashed an ever-growing number of attractive simulation techniques but no data that they improve knowledge or skill competencies.
An evaluation of the literature only raises more questions but does not provide any definitive answers. There are no data regarding the optimal method to evaluate and monitor progress in first aid education. Four LOE 1 studies — and 1 LOE 2 study with well-defined populations explored evaluation during resuscitation training, but no conclusions can be drawn because a variety of methods were used.
There are no data for or against any method of evaluating or monitoring a first aid provider trainee's educational progress. Well-designed studies are needed to evaluate the optimal evaluation strategy method, timing, duration of first aid courses. There are no studies evaluating the effect of simulation in first aid education. In other medical educational settings, simulations have been used successfully both in education and in testing. One LOE 1 study showed the benefit of using simulation as an evaluative tool. Two LOE 2 studies , showed that ACLS training using simulation is an effective training method for initial patient management skills.
In these studies, simulation tools and simulated patients produced identical or better educational outcomes than either traditional lecture-based or clinical-based learning for ACLS, advanced trauma life support, or the equivalent. In first aid training, the use of simulation appears to improve participant learning if it is accompanied by other effective teaching methods.
Well-designed studies to compare training using simulation with didactic lectures and other pedagogic methods are needed. Well-designed studies on the efficiency of first aid providers trained using simulation versus other pedagogic methods are also needed. There are no data to support a recommendation for the frequency needed for first aid retraining. Evidence from 1 study suggested that video retraining in first aid at 1 week, 1 month, and 13 months after initial training produces better retention of skills than no retraining over this period.
There are insufficient data to recommend a specific frequency of retraining in first aid in order to retain skills and knowledge. Well-designed studies are needed to evaluate self-instruction versus a traditional first aid refresher course.
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